Objective    To explore the safety and effectiveness of different interventional approaches for the treatment of patent ductus arteriosus (PDA) in children. Methods    The children (≤7 years) who underwent interventional treatment for PDA from 2019 to 2020 in our hospital were retrospectively included. The patients were divided into 3 groups according to the procedures: a conventional arteriovenous approach group, a simple venous approach group, and a retrograde femoral artery approach group. The clinical efficacy of the patients was compared. Results     A total of 220 patients were included. There were 78 males and 142 females, with an average age of 3.21±1.73 years, weight of 14.99±5.35 kg, and height of 96.19±15.77 cm. The average diameter of the PDA was 3.35±1.34 mm. A total of 85 patients received a conventional arteriovenous approach, 104 patients received a simple venous approach, and 31 patients received a retrograde femoral artery approach. The diameter of PDA in the retrograde femoral artery group was smaller than that in the other two groups (3.44±1.43 mm vs. 1.99±0.55 mm; 3.69±1.17 mm vs. 1.99±0.55 mm, P<0.001); the contrast medium usage [40 (30, 50) mL vs. 20 (20, 30) mL; 35 (25, 50) mL vs. 20 (20, 30) mL, P≤0.001] and operation time [32 (26, 44) min vs. 25 (23, 30) min; 29 (25, 38) min vs. 25 (23, 30) min, P<0.05] in the simple venous approach group were significantly less or shorter than those in the other two groups; the length of hospital stay of the conventional arteriovenous group was longer than that in the other two groups [3 (3, 5) d vs. 4 (3, 6) d; 4 (3, 5) d vs. 4 (3, 6) d, P<0.05]. There was no significant difference in postoperative complications. Conclusion    It is safe and effective to close PDA through simple venous approach. The retrograde femoral artery approach has the advantage of simplifying the surgical procedure for PDA with small diameters.

Objective:To explore the feasibility of three-dimensional CT axial sequence assisted volumetric measurement (CTAS) in evaluating atrial septal defect (ASD).Methods:The patients with single secundum ASD who successfully underwent interventional therapy in Fuwai Hospital from January 2016 to December 2019 were retrospectively collected. The patients underwent coronary CT angiography (CTA) before and on the second day after closures, and DSA examinations during operation. A total of 52 cases met the inclusion conditions, among them, there were 37 patients with large defects which had deficient inferior rims ≤3 mm, and 15 patients with severe pulmonary arterial hypertension that occluded with fenestrated ASD occluder. The CT data of patients before and after operation were reconstructed by CTAS. Then the anatomical structure of ASD before the operation was evaluated, including the long diameter and short diameter of ASD, and the CT three-dimensional volume diameter of ASD was calculated by using the equivalent circle conversion formula of ellipse. The waist diameter of occluder and rims of the ASD were measured after occlusion on postoperative CT three-dimensional volume reconstruction images. Meanwhile, the deployed occluder waist dimension was measured in DSA examination during the operation by simulating the balloon measurement of ASD. Lastly, paired t-test and consistency analysis were carried out among the values of parameters. Results:Before operation, the equivalent circle diameter of ASD was (32.3±5.4) mm measured by CTAS. After ASD occlusion, the size of the waist dimension measured by DSA and CTAS were (32.5±4.9) mm and (32.6±4.9) mm. There were no significant differences between them ( P>0.05). There were also no significant differences for each rims of the ASD pre and post operation on CTAS except for the inferior rims and the total length of atrial septum in superior-inferior direction ( P>0.05). Conclusion:As an alternative to balloon sizing, CTAS can be used as a reference standard to conduct ASD interventional treatment.

Objective: To explore the short and mid-term efficacy of device closure of patent foramen ovale (PFO) for treating the patients with PFO combining cryptogenic stroke (CS) and transient ischemic attack (TIA). Methods: A total of 56 PFO patients with CS and TIA receiving device closure in our hospital from 2009-05 to 2015-12 were retrospectively studied. Transthoracic echocardiography (TTE), electrocardiogram (ECG), chest X-ray were examined at 24h, 1 month, 3 and 6 months after theoperation; telephone visit was conducted every 6 months thereafter. Results: There were 54/56 PFO patients combining CS and 2 combining TIA; 53 (94.6%)patients received PFO occluder from Starway medical technology. Aspirin was used for 6 months after the operation. The patients were followed-up for the average of (34.67±23.24) months. No body suffered from post-operative stroke and TIA; no residual shunt was observed. Conclusion: The short and mid-term efficacy of device closure has been satisfactory for treating the patients with PFO combining CS and TIA; its overall clinical value should be further investigated in large population and long-term study.

Objective To screen the dual oxidase maturation factor 1 (DUOXA1) gene mutations in children with congenital hypothyroidism (CH) and thyroid goiter from Shandong Province,China,and to identify the gene mutation type and characteristics of DUOXA1 gene mutations in order to provide some evidence for gene diagnosis and therapy of CH.Methods A cohort of 52 cases of CH with thyroid goiter and 100 normal controls were selected according to neonatal screening system in Shandong Province whose genomic DNA was isolated from peripheral blood leukocytes with a standard phenol chloroform method.The whole coding sequence (CDS) of DUOXA1 gene was amplified with 8 pairs of sequence specific primers by using PCR.The PCR products were directly sequenced with Sanger sequencing to detect new mutations types of DUOXA1 gene.The sequencing data were compared to the DUOXA1 gene reference sequence(National Center for Biotechnology Information:RefSeq:NG_033105.1) to see if there was any mutation.Ax2 test was done for the gene frequency of discovered single nucleotide polymorphisms (SNP).Results There was no mutation in CDS of 52 CH patients with thyroid goiter and 100 normal controls.However,a SNP (rs75981505,c.398G ＞ T) which was an missense mutation and could lead to a change of the codon from CGC to CTC,was found in 9 CH patients with thyroid goiter and 11 normal controls in the exon 7.The corresponding amino acid arginine was replaced by histidine(p.Arg133His).There was no significant difference in the SNP rate between CH patients with thyroid goiter and normal controls (17.3％ vs 11.0％,x2 =1.24,P ＞ 0.05).Conclusion DUOXA1 gene mutation rate is very low which may not be the main cause of CH patients with thyroid goiter in the population of Shandong Province.

Objective To assess the feasibility and efficacy of Amplatzer duct occluder Ⅱ (ADOⅡ) in occlusion of aortopulmonary collateral arteries. Methods Seven patients,6 males and 1 female, with aortopulmonary collateral circulation diagnosed previously by cardiac Computed Tomograpy or cardioangiography from Mar 2014 to Apr 2015 were enrolled. All of them were treated with ADO Ⅱ. Results The age of the patients ranged between 5 - 71 months old and weight 4. 2 - 22. 0 kg. Successful hybrid approach was achieved in 6 of 7 patients. One patient failed the occlusion because of severe hypoxemia and mild-moderate residual shunt after catheter intervention. Total 15 aortopulmonary collateral vessels were embolized by 7 ADO-Ⅱ, 22 non-detachable coils ( Cook corp. ) and 2 detachable micro-coils ( Boston Scientific corp. ). Complete embolization was achieved in 2 patients,4 patients had mild residual shunt and 1 patient had mild-moderate residual shunt after the embolisation. No interventional complications recorded. Conclusions ADO Ⅱ has high controllability and suitable for application through small delivery catheter for minimally-invasive procedures to the vessels. It is a preferable alternative in treating pediatric patients with large and tortuous aortopulmonary collateral arteries.

Objective To study the thyroid hormone receptor β(TRβ)gene mutation types and characteristics in children with congenital hypothyroidism(CH)and thyroid dysgenesis(TD)from Shandong Province,and to provide theoretical basis for gene diagnosis and prenatal diagnosis. Methods Sixty cases of TD patients of which genomic DNA were isolated from peripheral blood leukocytes were selected by neonatal screening system in Shandong Province. The exon 6 to 12 of TRβ gene were amplified with 8 pairs of sequence specific primers using PCR and the first generation of sequencing method(Sanger method)to detect mutation. The sequencing results were compared with the TRβ gene reference sequence[National Center for Biotechnology Information(NCBI)Reference Sequence:NC 000003. 12]to see whether there was a mutation. Results Analysis of TRβ in 60 cases of CH patients with TD revealed no mutation was demonstrated in exons 6 - 12,but 2 single nucleotide polymorphism(SNP)( rs 3752874,c. 735C ﹥ T;rs79220627, c. 162G ﹥ A)were detected. Through the analysis,the 2 SNP were all synonymous mutations(Phe→Phe;Ser→Ser), without the change of the amino acids. Conclusions TRβ mutation rate is very low,which may not be the main mutation type in CH patients with TD in Shandong Province.

Objective To study the function of keratinocyte growth factor (KGF) on apoptosis of oral mucosal epithelial cells and to provide a basis for further investigation of the role of KGF in the occurrence and development of oral mucosal diseases. Methods Different concentrations of KGF (control group, 0 ng·mL-1; experiment 1 group, 5 ng·mL-1; experimental 2 group, 25 ng·mL-1; experiment 3 group, 50 ng·mL-1) were added in oral mucosa epithelial cells cultured in vitro. After training for 12, 24, and 48 h, cell morphology was observed under an inverted microscope. Apoptosis was detected by using a flow cytometry instrument, and mRNA expression of apoptosis-related genes Bcl-2 and Bax was detected by using Real-Time fluorescent quantitative detection. Results Cell adherence of the experimental group was more obvious than that of the control group, and the cell nucleolus of the experiment 3 group was obviously cultured at 48 h. After culturing for 48 h, the apoptosis rate and Bcl-2 and Bax mRNA expression among the four groups were statistically significant. The increase of KGF concentration, apoptosis rate, and Bax mRNA expression gradually reduced, whereas Bcl-2 mRNA expression increased (P<0.05). Conclusion KGF may inhibit epithelial cell apoptosis through upregulation of Bcl-2 mRNA and downregulation of Bax mRNA.

Objective To study the increased radiosensitivity of tumor cells by triterpene acids of loquat leaf (TAL) and mechanism.Methods C6 and MG63 cells were pretreated by TAL,and then were exposed to X-rays at 1,2,3,5,7 Gy.Clonogenic assay was used to evaluate those tumor cells survival fraction (SF) to calculate the sensitization enhancement ratios (SER) of TAL.The cellular micronuclei ratios of tumor cells were analyzed by micronuclei assay.Additionally,the changes of Rad51 and XRCC4 levels were observed by RT-PCR and Western blot.Results D0 values were decreased to 1.31 and 2.85 Gy in C6 and MG63 cells by TAL pretreatment respectively.The SER value of the effect of TAL on C6 and MG63 cells was 1.73 and 2.04,respectively.There was a statistical difference in the cellular micronuclei ratios between tumor cells with TAL above 2 Gy and those without TAL (C6:t =-8.372--2.476,P ＜0.05 ; MG63:t =-4.03--2.557,P ＜ 0.05).TAL attenuated the expression of XRCC4 at transcriptional and translational level,but not for Rad51,a key gene in homologous recombination repair (HRR).Conclusions TAL pretreatment could increase the lethal effect of X-rays on tumor cells in vitro.The mechanism might be involved in the inhibition of non-homologous end joining (NHEJ).

Objective To define the diagnostic criteria of cardiovascular magnetic resonance imaging in distinguishing isolated left ventricular noncompaction (LVNC) from lesser degrees of hypertrabeculation. Methods Twenty-five patients with LVNC, 39 with dilated cardiomyopathy ( DCM), 16 with aortic stenosis(AS), 15 with aortic regurgitation(AR) , 19 with hypertension (HT) and 22 normal subjects were enrolled in this study. Cardiac magnetic resonance imaging was performed to evaluate the left chamber diameter, functional parameters and noncompaction or hypertrabeculation of the left ventricle in diastole with one-way ANOVA. The left ventricle was divided into 17 segments for localizing all involved segments in this present study. Results The LVNC patients had the commonest myocardial segments involved (10±2)in all subjects. Each patient with LVNC was unexceptionally associated with apical noncompaction (17th segment) , which was seldom found in the other subjects. The lateral walls including 16th, 12th and 11th segments were the most vulnerable segments in all subjects, but nobody was found to involve the basal and mid septum including 2nd, 3rd, 8th and 9th segments. The end-diastolic NC/C (noncompaction/compaction) ratio was, on average, the greatest in patients with LVNC (3.3±0.6), compared with all other subjects(AS:1.0 ±0.3, AR:1.0 ±0.3,HT:0.8 ±0.1,healthy volunteers:0.9 ±0. 2) (F = 169. 62,P <0.05). Receiver operating characteristics analysis identified the end-diastolic NC/C ratio of>2.5 as a valuable parameter to distinguish LVNC from DCM.with values for sensitivity of 96.O%(24/25)and specificity of 94.9%(37/39),respectively.The mean number of NC/C ratio>2.5 segments in the LVNC patients was 4.0 ±2.0.while 8 of 39 patients with DCM had only one segment of NC/C ratio >2.5.Conclusions MRI is all exceUent imaging modality to diagnose LVNC and distinguish LIVNC from hypertrabeeulation.The criteria of LVNC is the NC/C ratio>2.5 in two or more than two segments of free ventricular walls associated with the left ventrieular apex involved.

marked hi-atrial dilation, near-normal ventricular chambers and near-normal ventricular thickness were presented. Conclusion MRI is an excellent imaging modality for the diagnosis of restrictive cardiomyopathy.